Back to your seats, ladies and gentlemen

The last five or six months have felt a little like an intermission. From late summer, through the fall and early winter, Dad has really been doing pretty well. In the fall, he even made it back to St. Louis on his own for a small family gathering. Over the past month or so, however, his walking has seemed slower, he’s seemed less steady transitioning from the sofa to standing, and now some medical issues appear to be creeping in that have me thinking of the lights the ushers flash in a theater lobby as a play is set to resume. It’s like I’m being ushered back to my seat so Dad’s drama can continue to unfold.

First, last month, came the visit to the skin doctor, for a look at three different lesions on Dad’s face. His primary care physician (PCP) had been tracking them for several months and had tried freezing one of them off in his office, but it returned within the month. The skin doctor took one look and said they needed to come off. Yes, it’s reasonable to ask, why deal with skin cancers on an 89-year-old, but the problem is they all fall within the area he shaves. And they bleed easily, even when he’s just drying his face on a towel – his towel can look like it’s been used as a tourniquet at a car-accident scene on his shower days. Fortunately, I was there to ask about anesthesia – “We can use general or a local,” the doctor said. “Well, he’s got kidney disease, so I think a general could be an issue – would you be checking with his kidney doctor?” I asked. “He’s got kidney disease? Is that in the notes? Oh, yeah, here it is. Well, I guess we’ll use a local, then.”

Next came the near-disaster as Dad pulled out of the driveway a couple weeks ago, which I wrote about in my last post. Watching that occur in almost exactly the same spot where my dog was hit and killed last summer had me shaking for an hour afterward. The driving-evaluation appointment at the rehab center is next week. As I noted in my last post, I’m not sure whether either possible outcome will give me any peace.

Through all this I’ve been having growing concerns about Dad’s stomach. He’s on a blood thinner to minimize the risk of clots that could develop around the stent he had placed in one of his legs last year. Blood thinners can be very hard on your stomach, and Dad already has a history of ulcers – in fact, a bleeding ulcer was part of what landed him in the hospital in St. Louis, just prior to me moving him out here with me. He was initially on two different stomach medicines, but one had to be withdrawn at the concern of the kidney doctor a couple months ago. Of course, my father is not someone who would adjust his diet to help manage this situation, and I started noting that he was belching a lot. Then, about a month ago, he mentioned he had had a bad stomach the night before and had had to get up to throw up. It happened again two weeks later. Plus, he’d gone through a bottle of Pepcid in a month. I called his PCP’s office, and they had him come in as a walk-in. We got sent home with an order for prescription-strength Pepcid (he’s now taking the equivalent of four “Max” strength Pepcids everyday, on top of his other stomach med), along with a test kit to check for blood in the stool. Last week, that test result came back positive, and we got a referral to specialist number 7, the gastroenterologist.

Again, it was a good thing I was here to run interference when the office of this latest team member called. That doctor wanted to take Dad in directly for a colonoscopy, without any kind of consult first. Having had my first experience with that wonderful exam this past fall, I know just how, um, draining the preparation can be. Really awful pictures started running through my head of Dad attempting to keep up with the repeated, urgent bathroom calls – the guy who, on his best days, can barely keep himself from toppling over as he gets up from the sofa. Then I began thinking about the strain the process could put on his kidneys. While the scheduler had me on hold while she checked dates, I began to panic a bit. When she came back on, I told her I wanted to check with his PCP before setting a date.

It turns out the PCP had intended there to be a consult before any procedure – the GI doc was just working on rote procedure: blood in stool = colonoscopy. The nurse from the PCP’s office told me that he was also concerned about a possible medical impact. So, now there will be blood tests, an appointment with the PCP and another with the kidney doctor before Dad sees the GI doc, and that visit will be a consult, not a colon exam.

Which all adds up to blood tests, three different doctor appointments, skin surgery and a driving evaluation in the next three weeks. And, by the way, I’m completely underwater with work. Yes, I think I see an usher attempting to flag me down… the performance must be starting up again.